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Organization
WESTCOAST CHILDREN'S CLINIC
Active
Organization
WESTCOAST CHILDREN'S CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
APRIL DESIREE FERNANDO PHD (CLINICAL DIRECTOR)
(510) 269-9098
Entity
Organization
Contact information
Practice address
3301 E 12TH ST STE 259, OAKLAND, CA 94601-2940
(510) 269-9030
(510) 269-9031
Mailing address
3301 E 12TH ST STE 259, OAKLAND, CA 94601-2940
(510) 269-9030
(510) 269-9031
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
81931
MEDI-CAL PROVIDER NUMBER
CA
Enumeration date
12/19/2006
Last updated
08/07/2007
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